Document Type

Article

Publication Date

12-1-2021

Publication Title

Nature Communications

Department

Department of Psychological and Brain Sciences

Abstract

The brain systems underlying placebo analgesia are insufficiently understood. Here we performed a systematic, participant-level meta-analysis of experimental functional neuroimaging studies of evoked pain under stimulus-intensity-matched placebo and control conditions, encompassing 603 healthy participants from 20 (out of 28 eligible) studies. We find that placebo vs. control treatments induce small, widespread reductions in pain-related activity, particularly in regions belonging to ventral attention (including mid-insula) and somatomotor networks (including posterior insula). Behavioral placebo analgesia correlates with reduced pain-related activity in these networks and the thalamus, habenula, mid-cingulate, and supplementary motor area. Placebo-associated activity increases occur mainly in frontoparietal regions, with high between-study heterogeneity. We conclude that placebo treatments affect pain-related activity in multiple brain areas, which may reflect changes in nociception and/or other affective and decision-making processes surrounding pain. Between-study heterogeneity suggests that placebo analgesia is a multi-faceted phenomenon involving multiple cerebral mechanisms that differ across studies.

DOI

10.1038/s41467-021-21179-3

Original Citation

Zunhammer, M., Spisák, T., Wager, T.D. et al. Meta-analysis of neural systems underlying placebo analgesia from individual participant fMRI data. Nat Commun 12, 1391 (2021). https://doi.org/10.1038/s41467-021-21179-3

COinS